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General NPI Number Information
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NPI Number | 1497945331
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Entity Type | Individual
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Provider Name | CARLOS NUNEZ M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/26/2007
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Last Update Date | 09/23/2010
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Provider Practice Location Address
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Address Line | 1701 W SUPERIOR ST
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City | CHICAGO
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State | IL
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Zip | 60622-5646
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Country | US
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Telephone | 312-432-2774
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Fax |
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Provider Business Mailing Address
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Address Line | 1413 W SUPERIOR ST APT. 1F
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City | CHICAGO
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State | IL
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Zip | 60642-5249
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Country | US
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Telephone | 520-975-9974
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 036.121908
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License Number State | IL
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